十二指肠癌的诊治分析

目的 提高十二指肠癌的诊治水平。方法 对45例十二指肠癌的诊治方法及预后作用回顾性分析。结果 行纤维十二指肠镜检查的十二指肠癌确诊率为95%（20/21），十二指肠X线低张造影检出率为96%（22/23），腹部B超及CT的检出率分别为29%（13/45）及73%（19/26），5例行核磁共振（MRI）检查，4例显示肿瘤。手术治疗44例，肿瘤切除率为53%（24/45），根治性切除率为42%（19/45）。根治术后1、3、5年生存率分别为91%、39%、26%，肿瘤未切除组的中位生存期仅为5个月。结论 联合应用纤维十二指肠镜和十二指肠低张造影能较理想地诊断各段十二指肠肿瘤。B超、CT及MRI均能判断梗阻性黄疸者的梗阻部位，且有助于检出转移瘤。手术切除肿瘤是有效的治疗方法。

Diagnosis and treatment of carcinoma of the duodenum

ObjectiveTo improve the diagnosis and treatment of duodenal carcinoma (DC).Methods A retrospective study was made on the diagnosis, treatment and prognosis of 45 duodenal carcinoma patients. Results The detection rate of DC by duodenoscopy was 95% (20/21), 96% (22/23) by hypotonic duodenography, 29% (13/45) by B ultrasound, 73% (19/26) by CT, and 80% (4/5) by MR. Forty four cases underwent surgery with resection rate of 53% (24/45), radical resection rate of 42% (19/45). The postoperative (radical resection) 1, 3, 5 year survival rate was 91%, 39%, and 26%, while the median survival time was 5 months in cases with unresectable tumor. Conclusions Duodenoscopy and hypotonic duodenography are ideal tools for the diagnosis of DC. For DC cases with obstructive jaundice, B ultrasound, CT and MR could show the obstructive portion and the metastasis.Radical resection is the mainstay for a long term survival.